Echocardiographic Detection of Cardiac ... - Wiley Online Library

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Jul 6, 2015 - As survival rates for childhood cancer improve, reducing the long-term toxicities of treatment has emerged as a priority in pediatric oncology.
Pediatr Blood Cancer 2015;62:2197–2203

Echocardiographic Detection of Cardiac Dysfunction in Childhood Cancer Survivors: How Long Is Screening Required? Aliya Ramjaun,

1 MSc,

Eman AlDuhaiby, MD, FRCPC,2 Sameera Ahmed, MSc,1 Lisa Wang, MSc,3 Eric Yu, Paul C. Nathan, MD, MSc, FRCPC,5 and David C. Hodgson, MD, MPH, FRCPC1,5,6*

Background. Childhood cancer survivors treated with anthracycline chemotherapy are at an increased risk of long-term cardiac toxicity, and guidelines recommend that exposed survivors undergo echocardiography every 1–5 years. However, it is unclear whether survivors should undergo echocardiographic screening indefinitely, or if a period of echocardiographic stability indicates that screening is no longer necessary. The objective of this study was to evaluate the outcomes of echocardiographic screening to aid in the refinement of existing guidelines. Methods. We retrospectively analyzed the results of echocardiographic screening in a cohort of adult survivors of childhood cancer treated with anthracyclines and/or cardiac radiation therapy. Interval regression analysis was performed to identify predictors of singleepisode or sustained abnormal echocardiograms. Results. The cohort constituted 333 survivors, with median follow-up time of 15.8


years post-treatment (range: 5.0–47.9), and median age at treatment of 8 years (range: 1.5–18). Forty-nine survivors had an abnormal echocardiogram (14.7%), and 29 (8.7%) had reproducible abnormal findings. An ongoing continual increase in the incidence of sustained echocardiographic abnormality was seen among patients treated with >250mg/ m2 doxorubicin at age

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